Odontogenic keratocyst: the northwestern USA experience.

Odontogenic keratocyst (OKC) is a cyst of tooth origin with an aggressive clinical behavior including a high recurrence rate. OKC demographics in the northwestern United States are presented and compared to those reported elsewhere. A total of 430 cases were obtained from 393 patients of the northwest region over a period of 15 years. Data evaluated included: site, gender, age, race, and association with bifid-rib basal cell nevus syndrome (Gorlin syndrome). Site distribution of the northwest group was similar to that of international groups. For the northwest group, the most common lesion location was the body of the mandible. Gender distribution in the northwest group appeared similar to other reports made in Denmark, England, Japan, and other regions in the United States. However, when gender distribution was compared by decade of life, the northwest group had the largest cluster of males in the fourth decade and of females in the second decade. The greatest frequency in both genders occurred in the third decade. There were 18 of 258 (6.9%) male patients with OKC under age 10 in the northwest group and nearly 80% of the patients were Caucasian. The race factor is rarely described in other reports. Gorlin's syndrome was present in 5% of the patients, with a higher distribution in the first and second decades. In conclusion, this is the first report of OKC cases from the Pacific Northwest region of the United States of America.

Effect of vitamins A, C and E on normal and HPV-immortalized human oral epithelial cells in culture.

There is experimental and epidemiological evidence that antioxidant vitamins can inhibit carcinogenesis. Since immortalization by Human Papilloma Virus (HPV) is one possible early step towards carcinogenesis in oral epithelia, we studied the differential effect of vitamins A, C and E on HPV-immortalized oral epithelial cells (IHGK) as compared to the normal counterpart. The dose response was determined by morphology, cell cycle by flow cytometry, and growth curve by cell number. The optimum dose in terms of inhibitory effect vs. toxicity was determined for each vitamin by morphology. Optimum doses were: vitamin A--1.4 x 10(-5) M, vitamin C--10(-3) M, and vitamin E--10(-6) M for both HPV-immortalized and normal cells. Growth curve showed reduction of proliferation by all three vitamins, with vitamins A and E more effective than C for both cell types. Flow cytometry showed that vitamins A and E reduced the percentage of cells at G2 phase of cell cycle and indicated arrest in the S phase. This effect was greatest in the immortalized cells with a 50% and 35% decrease of G2 for vitamins A and E respectively, whereas the normal counterpart showed a 48% decrease for A and a 12% increase for E. By organotypic culture, the morphology was not markedly different between the vitamin-treated and the control cells, except for a slight increase in the keratinization of normal cells with vitamin A. Also noted was a reduction in number of cell layers from five layers or more for controls to only one or two for vitamin E. In conclusion, we have demonstrated that the antioxidant vitamins inhibit proliferation, and show a preferential effect on IHGK cells.

Uterine arteriovenous malformation necessitating hysterectomy with bilateral salpingo-oophorectomy in a young pregnant patient.

This case report describes a 31-year-old woman at 8 weeks' gestation with large arteriovenous malformation of the uterus involving bilateral uterine and ovarian arteries. She had a history of multiple pregnancy losses, as well as spontaneous copious vaginal hemorrhage. The patient underwent an embolization procedure followed by total abdominal hysterectomy and bilateral salpingo-oophorectomy. The uterus was very small (30 g) despite its gravid status, and the overall microscopic findings indicated Müllerian system hypoplasia in addition to vascular malformation.